Oksenberg A, Khamaysi I, Silverberg D S
Sleep Disorders Unit, Loewenstein Hospital-Rehabilitation Centre, Raanana, Israel.
Eur Respir J. 2001 Aug;18(2):340-6. doi: 10.1183/09031936.01.00038101.
Several studies have reported changes in apnoea characteristics across the night in patients with obstructive sleep apnoea (OSA). However, the effect of body posture on these changes has not been evaluated. The purpose of this study was to assess how body posture influences sleep apnoea characteristics across the night in severe OSA. Polysomnograms of 30 patients with severe OSA who had > or = 30 apnoeic episodes in the lateral position and 30 in the supine position during Stage 2 sleep, in the early, middle and late sleep periods were analysed. For each of the 30 events in each body position, the following variables were evaluated: apnoea duration; minimum saturation; change in saturation; duration of arousal; maximum snoring loudness and change in cardiac frequency. Although at any time during the night, apnoeas in the supine posture were more severe than those in the lateral position, a time effect across the night was found only for apnoea duration, change in cardiac frequency and duration of arousal. Body position did not affect the time trend for these variables across the night. The best fit for the changes of these three variables across the night was a quadratic time trend. It was concluded that in severe obstructive sleep apnoea during Stage 2 sleep, body position does not significantly affect the time trends of apnoea characteristics across the night. These data provide support for the participation of sleep-dependent mechanisms (homeostatic and circadian) in the determination of apnoea characteristics across the night.
多项研究报告了阻塞性睡眠呼吸暂停（OSA）患者夜间呼吸暂停特征的变化。然而，体位对这些变化的影响尚未得到评估。本研究的目的是评估体位如何影响重度OSA患者夜间的睡眠呼吸暂停特征。分析了30例重度OSA患者的多导睡眠图，这些患者在第二阶段睡眠的早期、中期和晚期，侧卧位时有≥30次呼吸暂停发作，仰卧位时也有30次呼吸暂停发作。对于每个体位的30次事件中的每一次，评估以下变量：呼吸暂停持续时间；最低血氧饱和度；血氧饱和度变化；觉醒持续时间；最大打鼾响度和心率变化。尽管在夜间的任何时候，仰卧位的呼吸暂停比侧卧位更严重，但仅在呼吸暂停持续时间、心率变化和觉醒持续时间方面发现了夜间的时间效应。体位并未影响这些变量在夜间的时间趋势。这三个变量在夜间变化的最佳拟合是二次时间趋势。得出的结论是，在第二阶段睡眠的重度阻塞性睡眠呼吸暂停中，体位不会显著影响夜间呼吸暂停特征的时间趋势。这些数据为睡眠依赖性机制（稳态和昼夜节律）参与夜间呼吸暂停特征的决定提供了支持。
